C09973488 / invoice 10000

Appointment Reason: ACTH Stimulation Blood Test, Appointment Notes: ACTH stim + general check over for other meds Admit form ready, O has Trilostane to collect alsoEstimate: $489 + Trilostane (O collected, will pay on discharge)How is the pet going? Any changes or concerns?: See "Extras", slowing down a bitTrilostane dose:  0.6 ml of 50mg/ml solution = 30 mg dose,  at 8amGiven TWICE daily Time breakfast given: Offered 8am but did not eatDoes your pet have any food allergies or requirements?  NilOther medications:  Losec, Iramine & gabapentin this morning 8amExtras: General check up, O's away for 6 weeks was staying with sitter, a bit puffy on L side of face (photos attached). Scripts (written) for gaba, iramine (8mg) & losecContact: 0488188294KEHistory: Doing fine, last week Examine:  Muzzled: mm pinkWas on gabapentin for pain for possible pain for enlarged organs EDDU normal no vdcs Once noted a swelling Treatment: Blood taken for 0hr sample22 g intravenous catheter placed in FLSynacthen  0.21   ml IV, (= 5 ug/kg) flushed in with hep salineBlood taken for 1hr sample. Removed iv catheterPlan:  wait for blood results=========SCRIPTS: needs recheck for these in 6mo. 25/6/23 - Pet Oncologist report: "Unfortunately, Wynter has confirmed nodal metastasis to two different lymph nodes (which is considered systemic and not locoregional lymph node metastasis). With surgery alone, Wynter’s expected median survival time is <3 months. However, with systemic therapy, depending on the specific treatment chosen, the response rates are 40-90% and overall median survival times of between 3 to 12 months. However, this is highly variable. With aggressive therapy, a small subset of dogs can experience long-term survival, and there is a small subset of dogs that do not respond to therapy and are still humanely euthanised within three months, despite an aggressive treatment approach." PLAN: Only put on omeprazole and antihistamines and has survived over 2 years - so has not progressed as expected. As dog tolerating medication ok will continue ongoing. Rx: Losec (Omeprazole) 10mg x 30Directions: give 1 tablet morning and nightFor animal treatment only.Number of repeats: 11Unique visit number: 506236Rx: Gabapentin 100mg capsules x 100Directions: Give 1 capsules TWICE a dayFor animal treatment only.Number of repeats: 1Unique visit number: 506236Rx: Iramine (Chlorpheniramine) tablet 8mg tablet x 100Directions: Give one tablet twice dailyFor animal treatment only.Number of repeats: 1Unique visit number: 506236     Vital Signs    Weight: 10.6;